{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:04:59Z","timestamp":1787025899754,"version":"build-2736575974"},"reference-count":29,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T00:00:00Z","timestamp":1712016000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T00:00:00Z","timestamp":1712016000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuromuscular Diseases"],"published-print":{"date-parts":[[2024,4,30]]},"abstract":"<jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>Background\/Objective:<\/jats:title>\n                    <jats:p>Myasthenia Gravis (MG) is an autoimmune disorder characterized by pathogenic autoantibodies (AAbs) targeting nicotinic acetylcholine receptors (AChR), disrupting neuromuscular communication. RadioImmunoPrecipitation Assay (RIPA) is recommended to detect AChR AAbs, but its complexity and radioactive requirements limit widespread use. We compare non-RIPA anti-AChR immunoassays, including Cell-Based Assay (CBA) and two ELISA kits, against the gold standard RIPA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>Methods\/Results:<\/jats:title>\n                    <jats:p>\n                      145 samples were included with medical indication for anti-AChR testing. By the RIPA method, 63 were negative (RIPA-Neg &lt;\u200a0.02 nmol\/L), 18 were classified as B\n                      <jats:italic toggle=\"yes\">orderline<\/jats:italic>\n                      (\u22650.02 \u20131 nmol\/L), and 64 were positive (RIPA-Pos\u200a&gt;\u200a1 nmol\/L). The competitive ELISA showed poor agreement with RIPA (Kappa\u200a=\u200a0.216). The indirect ELISA demonstrated substantial agreement with RIPA (Kappa\u200a=\u200a0.652), with \u223c76% sensitivity and \u223c94% specificity for MG diagnostic. The CBA, where fixed cells expressing clustered AChR were used as substrate, exhibited almost perfect agreement with RIPA (Kappa\u200a=\u200a0.984), yielding \u223c98% sensitivity and 96% specificity for MG. In addition, a semiquantitative analysis showed a strong correlation between CBA titration, indirect ELISA, and RIPA levels (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      \u200a=\u200a0.793 and\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      \u200a=\u200a0.789, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The CBA displayed excellent analytical performance for MG diagnostic when compared to RIPA, making it a potential replacement for RIPA in clinical laboratories. Some solid-phase assays (such as the indirect ELISA applied here), as well as CBA titration, offer reliable options to estimate anti-AChR AAb levels after confirming positivity by the CBA.\u2225<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3233\/jnd-230210","type":"journal-article","created":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T14:02:52Z","timestamp":1712066572000},"page":"613-623","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Detection of Autoantibodies Against the Acetylcholine Receptor, Evaluation of Commercially Available Methodologies: Fixed Cell-Based Assay, Radioimmunoprecipitation Assay and Enzyme-Linked Immunosorbent Assay"],"prefix":"10.1177","volume":"11","author":[{"given":"Larissa","family":"Diogenes","sequence":"first","affiliation":[{"name":"Disciplina de Reumatologia, Departamento de Medicina, Universidade Federal de S\u00e3o Paulo, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Dellavance","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Imunologia, Departamento de Pesquisa e Desenvolvimento, Laborat\u00f3rio Fleury, S\u00e3o Paulo, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle Cristiane","family":"Baldo","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Imunologia, Departamento de Pesquisa e Desenvolvimento, Laborat\u00f3rio Fleury, S\u00e3o Paulo, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Cristina","family":"Gozzi-Silva","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Imunologia, Departamento de Pesquisa e Desenvolvimento, Laborat\u00f3rio Fleury, S\u00e3o Paulo, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kethellen","family":"Gomes","sequence":"additional","affiliation":[{"name":"Disciplina de Reumatologia, Departamento de Medicina, Universidade Federal de S\u00e3o Paulo, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica Simon","family":"Prado","sequence":"additional","affiliation":[{"name":"Disciplina de Reumatologia, Departamento de Medicina, Universidade Federal de S\u00e3o Paulo, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Eduardo C.","family":"Andrade","sequence":"additional","affiliation":[{"name":"Disciplina de Reumatologia, Departamento de Medicina, Universidade Federal de S\u00e3o Paulo, Brasil"},{"name":"Divis\u00e3o de Imunologia, Departamento de Pesquisa e Desenvolvimento, Laborat\u00f3rio Fleury, S\u00e3o Paulo, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0660-2857","authenticated-orcid":false,"given":"Gerson Dierley","family":"Keppeke","sequence":"additional","affiliation":[{"name":"Disciplina de Reumatologia, Departamento de Medicina, Universidade Federal de S\u00e3o Paulo, Brasil"},{"name":"Departamento de Ciencias Biom dicas, Facultad de Medicina, Universidad Cat\u00f3lica del Norte, Coquimbo, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,4,2]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199406233302507"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006986.pub3"},{"key":"e_1_3_6_4_2","doi-asserted-by":"crossref","unstructured":"HuangEJ WuMH WangTJ HuangTJ LiYR LeeCY Myasthenia Gravis: Novel Findings and Perspectives on Traditional to Regenerative Therapeutic Interventions. 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